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Necrotizing fasciitis in childhood
J J Murphy1, R Granger, G K Blair
1Department of Surgery, British Columbia's Children's Hospital, Vancouver.
Journal of Pediatric Surgery
|August 1, 1995
Summary
Necrotizing fasciitis is a rare but serious soft tissue infection in children. Aggressive treatment including surgery and antibiotics is critical, especially for neutropenic patients, though mortality remains a concern.
Area of Science:
- Pediatric Infectious Diseases
- Surgical Infections
- Immunocompromised Hosts
Background:
- Necrotizing fasciitis is uncommon in children.
- The study reviewed five pediatric cases treated in 1993.
- Three patients had neutropenia due to chemotherapy.
Observation:
- All five patients underwent aggressive surgical debridement, wound care, antibiotics, and nutritional support.
- Neutropenic patients received granulocyte-colony stimulating factor and transfusions.
- One patient died from sepsis and bone marrow graft failure; others recovered.
Findings:
- Necrotizing fasciitis may be increasing in pediatric populations, potentially linked to chemotherapy and bone marrow transplantation.
- Early diagnosis and aggressive surgical intervention are crucial.
- Mortality is significant, particularly in neutropenic children, with leukocyte response potentially indicating prognosis.
Implications:
- Antimicrobial therapy must cover Pseudomonas and enteric gram-negative organisms, common in immunocompromised children.
- Further research is needed to understand the rising incidence and improve outcomes.
- This study highlights the critical need for prompt and multidisciplinary management of pediatric necrotizing fasciitis.